A randomized trial of mailed HPV self-sampling for cervical cancer screening among ethnic minority women in South Florida
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HPV self-sampling has previously been shown to increase cervical cancer screening among ethnic minority and immigrant women. We conducted a randomized pragmatic trial to examine the effectiveness of HPV self-sampling delivered via in-person versus by US mail for medically underserved Hispanic, Haitian, and non-Hispanic Black women living in South Florida.
We randomized women aged 30–65 who had not completed Pap smear screening in the past 3 years into two groups: (1) HPV self-sampling delivered in-person (IP) by a community health worker (CHW; IP + SS) or (2) HPV self-sampling delivered via US mail (SS + Mail). Our primary outcome was HPV self-sampling completion by 6-month post-study enrollment.
We enrolled 600 women. Approximately 65% were Hispanic and 35% were Haitian or non-Hispanic Black. Nearly half (43%) had an income of less than $20,000/year and 67% were uninsured. In intent-to-treat analyses, 71.6% of participants in the SS + Mail group and 81.0% of participants in the IP + SS group completed HPV self-sampling.
Mailed HPV self-sampling is an effective strategy to increase cervical cancer screening among underserved immigrant and ethnic minority women.
KeywordsCervical cancer screening HPV Immigrant Women Self-sampling
We wish to thank our study team who played a critical role in ensuring completion of the study. These include our Community Health Workers, Valentine Cesar (Center for Haitian Studies), Maria Azqueta (Citrus Health Inc.), and Linabell Lopez (Community Health Inc.), our Health Choice Network (HCN) Project Manager, Ludmilla Paul, as well as, our data managers Carmen Linarte and Feng Miao.
This work was supported by the National Cancer Institute (1R01CA183612).
Compliance with ethical standards
Conflict of interest
The authors have no potential conflict of interest to disclose.
All procedures performed in our study were in accordance with the ethical standards of our institutional review board and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in the study.
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